This week, for reasons I can’t quite explain, an unusual number of breastfeeding patients showed up at my clinic. Some suffered from constipation, others from insomnia, allergies, general weakness with excessive sweating, skin inflammation, or insufficient milk production. One patient had even been beaten black and blue by her husband. Nearly all of them had sought help from Western medicine first—and, predictably, every single one was turned away. The reason was simple: it’s not safe to take medication while breastfeeding.

As a doctor, the last thing I want is to watch these women endure their suffering in silence. Yet the question of medication during breastfeeding has been turned into something far bigger than a medical issue—it has become a social problem, largely shaped by the Western medical establishment.

I’ve previously written about medication use during pregnancy, and earlier this year I even assigned my graduate students a research project on the topic. The truth is, whether we’re talking about pregnancy, breastfeeding, infants, or the elderly, the greatest obstacle to rational medication use is not a scientific one—it’s the ethical dilemma born from scientific uncertainty.

Chinese herbal formulas, as a therapeutic approach whose safety and efficacy cannot yet be “verified” to the standards of modern evidence-based medicine, exist in a gray zone. Whether to prescribe them rests entirely on the physician’s own judgment. Beyond the contraindicated herbs explicitly listed in the pharmacopoeia, these medicines are legally and reasonably prescribable. If all goes well, everyone is happy. But if anything goes even slightly wrong, the prescribing doctor may find themselves in serious trouble.

Despite these risks, I still believe in making a comprehensive, individualized assessment. A mother’s physical and emotional state has a profound impact on the quality of her breast milk. Refusing all medication outright can harm both mother and baby. And from neither a traditional Chinese medicine perspective nor a modern scientific one can it be proven that judicious herbal intervention harms infant development. So if Chinese medicine can relieve a mother’s suffering, I believe we ought to help her.

The inability to disprove is not proof of safety.

The inability to confirm is not proof of danger.

If we insisted on absolute certainty before acting, every hospital in the world might as well shut its doors.

这周莫名地出现了许多处于哺乳期的病人，她们或是便秘，或是失眠，或是过敏，或是体弱多汗，或是皮肤火毒，或是乳汁不足，更有甚者被老公打的遍体紫癍，基本上都去西医那里看过，毫无疑问全部被拒绝，理由很简单，哺乳期用药不安全。

作为医生，我不想看到她们生生熬过这些痛苦，但哺乳期用药已经被西医生生弄成了一个社会问题。

之前有文章讨论过妊娠期用药的问题，在上半年研究生的课程中我还专门给学生们布置过作业，其实不管妊娠期、哺乳期、婴幼儿还是老年人用药，最大的阻碍不是科学问题，而是由科学问题带来的伦理问题。

中药复方作为目前无法被验证安全性和有效性的一种治疗方法，能否使用完全取决于医生本身，除了药典明确规定的禁忌药物之外，药是可以吃的，合法合理，不出问题皆大欢喜，但凡出一点差错，可能会惹火烧身。

但是我还是坚持综合研判，母亲的状态很大程度上能够决定奶水的质量，如果坚持不用药，很有可能对母亲和婴儿双方都产生不良影响，而无论是从中医角度还是科学角度，也都无法证明药物的干预对婴儿的发育有害。所以如果中药能减轻痛苦，还是要帮助患者减轻一下的。

无法否定，不代表可以肯定。

不能肯定，不代表不能使用。

硬要较真的话，医院就可以关门了。